Epidemiology of resistant bacteria in acute-care and long-term care facilities

急症护理和长期护理机构中耐药菌的流行病学

• 批准号: 7758249
• 负责人: JON P FURUNO
• 金额: $ 13.14万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-15 至 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7758249
• 关键词: Acute; Address; Admission activity; Antibiotic Resistance; Antibiotics; Bacteria; Caring; Communicable Diseases; Data; Development; Disasters; Effectiveness; Elderly; Epidemiologist; Epidemiology; Geriatrics; Goals; Health system; Hospitals; Human; Incidence; Infection; Infection Control; Infection prevention; Intervention; Life; Literature; Long-Term Care; Microbiology; Mission; Modeling; Morbidity - disease rate; Movement; Outcome; Patient Transfer; Patients; Population; Prevalence; Prevalence Study; Public Health; Published Database; Relative (related person); Research; Resources; Risk; Secondary to; Testing; Training; aged; bacterial resistance; career; cohort; computerized; cost; cost effectiveness; design; high risk; mathematical model; methicillin resistant Staphylococcus aureus; mortality; pathogen; prevent; prospective; transmission process

DESCRIPTION (provided by applicant): Antibiotic resistance is an increasing public health problem that is associated with considerable morbidity, mortality and costs. Given the reduced pace of antibiotic discovery and the approaching demographic shift towards an increasingly aged population, antibiotic resistance among the geriatric population in both hospitals and long-term care facilities (LTCFs) represents an impending public health disaster. My long-term career goal is to help reduce the incidence of antibiotic-resistant infections in both hospitals and LTCFs. The purpose of this application is to provide me with opportunities for specific training in geriatric medicine, mathematical modeling, and infectious diseases to assist in my development into an infectious disease epidemiologist with expertise in geriatric medicine. This research plan is designed to provide these opportunities and will use a multi-disciplinary approach to assess three hypotheses related to colonization by methicillin-resistant Staphylococcus aureus (MRSA) in hospitals and LTCFs. MRSA is one of the most common antibiotic-resistant bacteria and a prevalent nosocomial pathogen. Appropriate understanding and quantification of the association between antibiotic use, patient movement, and colonization of patients with MRSA are necessary in order to optimize existing infection control efforts and to identify additional opportunities for control of these pathogens. Thus, my long- term goal and the goals of this project are consistent with the mission of NlAID in attempting to understand and ultimately prevent infectious diseases that threaten millions of human lives. The proposed study will utilize admission and biannual point prevalence studies at four LTCFs over two years, a prospective cohort of LTCF residents to assess both the prevalence of MRSA upon admission to acute care hospitals and outcomes associated with colonization by MRSA, and mathematical models to assess relative contributions of inter-facility patient movement on MRSA prevalence as well as the effectiveness and cost-effectiveness of infection control interventions targeting recently transferred patients in reducing the transmission of MRSA. These data are integral to the prevention of infections by MRSA and potentially other antibiotic-resistant bacteria.

描述（由申请人提供）：抗生素耐药性是一个越来越多的公共卫生问题，与大量发病率，死亡率和成本相关。鉴于抗生素发现的速度降低以及人口的临近转变朝着越来越老化的人群，医院和长期护理设施（LTCFS）的老年抗生素耐药性代表了即将来临的公共卫生灾难。我的长期职业目标是帮助减少医院和LTCF中抗生素耐药感染的发生率。该应用的目的是为我提供在老年医学，数学建模和传染病方面的特定培训的机会，以帮助我发展成为具有老年医学专业知识的传染病流行病学家。该研究计划旨在提供这些机会，并将使用多学科方法来评估与医院和LTCF中耐甲氧西林金黄色葡萄球菌（MRSA）相关的三个假设。 MRSA是最常见的抗生素抗生素细菌之一，并且是一种普遍的医院病原体。为了优化现有的感染控制工作并确定控制这些病原体的额外机会，需要适当了解和量化MRSA患者的抗生素使用，患者运动和定殖之间的关联。因此，我的长期目标和该项目的目标与NLAID试图理解并最终防止威胁着数百万人类生命的传染病的使命是一致的。拟议的研究将在两年内在四个LTCF进行入院和双年度的流行研究，这是LTCF居民的前瞻性同类群体评估MRSA在接纳急性护理医院的流行率和与MRSA殖民相关的急性护理医院的流行以及MRSA殖民的结果，以及对MRSA效应的促进和效率的促进，并评估了MRSA的效果，并在MRSA中促进了同类的效果。靶向的控制干预措施最近转移患者减少MRSA的传播。这些数据是预防MRSA和其他潜在抗生素耐药细菌感染不可或缺的。